Endoscope head, endoscope and albarran lever holding member

ABSTRACT

The invention refers to a housing sheath attachable to and detachable from an endoscope head body, which is provided on a distal side of an insertion portion of an endoscope. The housing sheath comprises: a sheath that is a hollow cylinder open at an attachment opening provided along a longitudinal direction of the hollow cylinder, and is provided with a tool opening cut out in a U-shape at a location facing the attachment opening; and an Albarran lever that is rotatably supported inside the sheath.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a divisional of U.S. patent application Ser.No. 16/087,903 filed Sep. 24, 2018, which is a U.S. National StageApplication of International Patent Application No. PCT/EP2017/069800filed Aug. 4, 2017, which claims the benefit of German PatentApplication No. 10 2016 114 881.4 filed Aug. 11, 2016. The disclosure ofeach of the above-noted applications is expressly incorporated herein byreference in its entirety.

The present invention relates to an endoscope head comprising anendoscope head body, in which at least one working channel is formed andin which an Albarran lever capable of being pivoted is provided at thedistal working channel end portion, and to an endoscope comprising suchan endoscope head. Further, the present invention relates to an Albarranlever holding member for an endoscope.

Such an endoscope head body can, for example, be applied to aduodenoscope, i.e. an endoscope for examining e.g. the esophagus or theduodenum, the bile duct, the gall bladder, the pancreatic duct, thepancreas, etc.

By means of the duodenoscope it is possible to reach the duodenumthrough the esophagus, the stomach and the pylorus.

The duodenoscope comprises optics (illumination means and camera)directed to the side (lateral). This may complicate inserting andadvancing the duodenoscope through the esophagus since a“forward-facing” observation is not easily possible. Only the stomach orthe duodenum provides enough room to bend the distal end of theduodenoscope by about 90° so as to enable forward viewing.

Further, at the working channel outlet, the duodenoscope comprises anAlbarran lever which, by means of pivoting, enables a precise deflectionof the tools advanced through the working channel.

After the duodenoscope has been used, it is subjected to reprocessing.The reprocessing must reliably prevent microorganisms such as bacteria,viruses, fungi, worms and spores from being transmitted. In the courseof reprocessing, the duodenoscope is initially cleaned manually in orderto remove all traces of organic material or chemical residues. Aftercleaning, a mechanical disinfection or sterilization is carried out.

It is the object of the present invention to provide an endoscope headcomprising an endoscope head body, which is easy to clean but alsoversatile. Moreover, an endoscope and an Albarran lever holding memberfor an endoscope shall be provided.

This object is achieved by an endoscope head comprising an endoscopehead body including the features of claim 1. Advantageous furtherdevelopments are described in the dependent claims.

Thus, an endoscope head has been provided which comprises an endoscopehead body, in which at least one working channel is formed, wherein anAlbarran lever capable of being pivoted is provided at the distalworking channel end portion. The Albarran lever can be inserted at theendoscope head body laterally to the axis of the endoscope head body andremoved from the endoscope head body laterally to the axis of theendoscope head body. Thus, the Albarran lever can be removed from theendoscope head body laterally to the axis of the endoscope head body andis easily detachable from the endoscope head body.

The endoscope head may comprise a housing sheath part at which theAlbarran lever is pivotally disposed, wherein the housing sheath partcan be applied at and removed from an outer circumferential portion ofthe endoscope head body laterally to the axis of the endoscope headbody. The housing sheath part and the Albarran lever may form a commonassembly which is separate from the endoscope head and can be treated asan individual unit. Hence, the Albarran lever provided on the housingsheath part is provided separately and detachably from the endoscopehead body. The Albarran lever can be separated from the endoscope headbody by the housing sheath part being removed from the endoscope headbody.

In the endoscope head, the housing sheath part may be formed as anelastic housing sheath part which can be spread apart and can becompletely separated from the endoscope head body, and which can includefastening means which fasten the housing sheath part to the outercircumferential portion of the endoscope head body. Thus, the assemblyconsisting of the housing sheath part and the Albarran lever can beeasily attached to the endoscope head. The fastening means can be formedas engagement means. Protrusions capable of engaging in recesses formedon the outer circumferential portion of the endoscope head body may beformed as engagement means on the housing sheath part.

The housing sheath part may be formed as a hollow cylinder whose sheathincludes an attachment opening extending along the cylinder extensiondirection and along the entire hollow cylinder. The hollow cylinder maybe elastically spread apart at the attachment opening thereof and placedon the outer circumferential portion of the endoscope head body. Thus,the housing sheath part can be easily and quickly detached from theendoscope head body.

On the hollow cylinder, on the side opposite to the attachment opening,a tool opening may be formed, through which a tool can project laterallyfrom the endoscope head body when the housing sheath part is placed onthe endoscope head body. When the housing sheath part is attached to theendoscope head body, the endoscope is ready for operation. Tools can beadvanced through the working channel to the Albarran lever whichappropriately changes the lateral alignment of the tools. In the courseof this, the tools project laterally from the endoscope head bodythrough the tool opening of the housing sheath part.

The fastening means may be formed as a hinge member. The housing sheathpart may comprise a hinge member which is hinged on the housing sheathpart and is able to close the attachment opening. When the hinge memberis closed, the housing sheath part can abut against the endoscope headbody along the entire outer circumferential portion of the endoscopehead body. In such a design, the housing sheath part is mounted to theendoscope head body in a fixed and stable manner. One side of the hingemember may be supported on the housing sheath part in a hinged mannerand the opposite side of the hinge member may include a closing means,e.g. a nose, capable of engaging at the housing sheath part. Due to theelasticity of the housing sheath part, the housing sheath part can thustightly abut against the endoscope head body in a correct position andwith a predefined tension.

The housing sheath part may comprise a protrusion extending radiallyinward, on which the pivot axis of the Albarran lever is rotatablysupported. Therefore, the housing sheath part is provided with theelements pivotally supporting the Albarran lever. The element (operatingelement) effecting the pivoting process of the Albarran lever may beprovided in the endoscope head body.

The housing sheath part and the Albarran lever may be formed as a unitdesigned as a single-use product. For example, the housing sheath partand the Albarran lever can form a common assembly which is manufacturedat low cost from plastic or any other suitable material. Thus, thecommon assembly consisting of the housing sheath part and the Albarranlever can be disposed of after a single use. When the endoscope is usedagain, a new assembly consisting of the housing sheath part and theAlbarran lever is placed on the endoscope head body.

The endoscope head body may comprise a pivotable operating element whichcan be operated from the proximal side and with which the Albarran leverreleasably engages when the housing sheath part is attached to theendoscope head body.

The endoscope head may comprise an ultrasonic head on the distal end ofthe endoscope head body and the portion of the endoscope head body wherethe Albarran lever can be applied at and removed from, may be situatedproximally from the ultrasonic head. In this way, an endoscope can beprovided which comprises an ultrasonic head on the distal end andincludes, proximally from the ultrasonic head, an Albarran lever whichis easily separable from the endoscope head.

In an alternative, an endoscope head according to the invention has beenprovided, the endoscope head comprising an ultrasonic head at the distalend and an Albarran lever arranged proximally from the ultrasonic head.

In a further alternative, an endoscope head according to the inventionhas been provided, the endoscope head comprising an ultrasonic headtherein and an Albarran lever arranged distally from the ultrasonichead. In this further alternative, a working channel and a movementtransmission channel are guided past the ultrasonic head.

In the endoscope head, the Albarran lever may be operated by means of amovement transmission mechanism, wherein the movement transmissionmechanism in the endoscope head acts via a movement transmission channeland the movement transmission channel is sealed against the environment.

The movement transmission mechanism may be, for example, a pulling wiremechanism, a wire mechanism (pushing wire or pulling wire), a hydraulicmechanism or a pneumatic mechanism, transmitting a movement generated ata proximal control element (e.g. a joystick) via the movementtransmission channel so as to actuate (pivot) the Albarran lever. In thecase of the solution by means of the hydraulic mechanism or thepneumatic mechanism, the movement transmission channel is a simplechannel which is sealed and filled with a movement transmission medium(hydraulic mechanism: e.g. water or another hydraulic medium; pneumaticmechanism: e.g. air).

Since the movement transmission channel and thus, the medium containedtherein (hydraulic medium, air, pulling wire or wire, etc.) is sealedagainst the environment, it is avoided that germs and contaminationsenter the movement transmission channel. Incidentally, the movementtransmission channel and the Albarran lever are completely separatedfrom each other.

Moreover, an Albarran lever holding member has been provided for anendoscope comprising an endoscope head in which at least one workingchannel is formed, wherein an Albarran lever capable of being pivoted isprovided at the distal working channel end portion of the endoscope; theAlbarran lever holding member including: a sheath element which can beplaced on the endoscope head and in which the Albarran lever ispivotally supported.

The sheath element may be formed as a laterally open cylinder whose openside can be placed on the endoscope head, and the Albarran leverpivotally supported in the sheath element may include an opening adaptedto be able to engage such that an operating element supported on theendoscope head can engage in the opening of the Albarran lever.

The Albarran lever holding member may be formed of plastic, for example,or any other suitable material. The Albarran lever holding member may bemanufactured, for example, by means of a 3D-printer or an injectionmolding method. The sheath element and the Albarran lever can bemanufactured separately and the Albarran lever can be installed in thesheath element in an assembly step.

The previously explained aspects of the present invention may beappropriately combined.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a perspective view of an inventive endoscope head of afirst embodiment in a disassembled state.

FIG. 2 shows a perspective view of the inventive endoscope head of thefirst embodiment in the assembled state.

FIG. 3 shows a perspective view of a housing sheath part of theinventive endoscope head of the first embodiment.

FIG. 4 shows a further perspective view of a housing sheath part of theinventive endoscope head of the first embodiment.

FIG. 5 shows a further perspective view of a housing sheath part of theinventive endoscope head of the first embodiment.

FIG. 6 shows a perspective view of an endoscope head body of theendoscope head of the first embodiment with an Albarran lever being in anon-pivoted state.

FIG. 7 shows a perspective view of the endoscope head body of theendoscope head of the first embodiment with the Albarran lever being ina pivoted state.

FIG. 8 shows a perspective view of the endoscope head of the firstembodiment obliquely from above, without the housing sheath part.

FIG. 9 shows a perspective view of an inventive endoscope head of asecond embodiment in a disassembled state.

FIG. 10 shows a perspective view of the inventive endoscope head of thesecond embodiment, with a housing sheath part being placed on theendoscope head.

FIG. 11 shows a perspective view of the inventive endoscope head of thesecond embodiment, with a hinge member of the housing sheath part beingclosed.

FIG. 12 shows a perspective view of the inventive endoscope head of thesecond embodiment with the hinge member of the housing sheath part onthe endoscope head being closed.

FIG. 13 shows a perspective view of the inventive endoscope head of thesecond embodiment, with a hinge member of the housing sheath part beingclosed.

FIG. 14 shows a perspective view of an inventive housing sheath part ofa third embodiment.

Below, the present invention is described in detail with reference tothe drawings and based on the embodiments.

The endoscope head of the present invention can be used in the field ofendoscopic ultrasound.

Endoscopic ultrasound (EUS) is a medical procedure in which endoscopy iscombined with ultrasound to obtain images of the internal organs e.g. inthe chest, abdomen and colon. EUS can be used to visualize the walls ofthese organs, or to look at adjacent structures. Combined with Dopplerimaging, nearby blood vessels can also be evaluated.

Endoscopic ultrasonography is most commonly used in the upper digestivetract and in the respiratory system. For the patient, the procedurefeels almost identical to the endoscopic procedure without theultrasound part, unless ultrasound-guided biopsy of deeper structures isperformed.

Ultrasound endoscopes are commonly used for diagnostic and therapeuticpurposes in the upper gastroenterology area. The tools in use arepenetrating the human tissue and are out of optical visibility, in thatmoment. In that case the ultrasound sensor still shows the way andlocation of the tools tip. Necessary tools can be controlled by thealbarranlever of the respective endoscope. The physician observes e.g.either the stomach or the duodenum with the optical camera as well astaking pancreatic biopsy with support from the EUS sensors view.

In particular, for endoscopic ultrasound of the upper digestive tract, aprobe is inserted into the esophagus, stomach, and duodenum during aesophagogastroduodenoscopy. Among other uses, it allows for screeningfor pancreatic cancer, esophageal cancer, and gastric cancer, as well asbenign tumors of the upper gastrointestinal tract. It also allows forcharacterization and biopsy of any focal lesions found in the uppergastrointestinal tract, such as esophageal tuberculosis. Further, thisprocedure can also be used to identify malformations and masses in thebile ducts and pancreatic ducts.

Endoscopic ultrasound is performed with the patient sedated. Theultrasound endoscope is passed through the mouth and advanced throughthe esophagus to the suspicious area. From various positions between theesophagus and duodenum, organs within and outside the gastrointestinaltract can be imaged to see if they are abnormal, and they can bebiopsied by a process called fine needle aspiration. Organs such as theliver, pancreas, and adrenal glands are easily biopsied, as are anyabnormal lymph nodes. In addition, the gastrointestinal wall itself canbe imaged to see if it is abnormally thick, suggesting inflammation ormalignancy.

The technique is highly sensitive for detection of pancreatic cancer.With respect to pancreatic cancer, by endoscopic ultrasound localmetastases can be detected. However, in combination with a CT scan whichprovides information on regional metastases, endoscopic ultrasoundprovides an excellent imaging modality for diagnosis and staging ofpancreatic carcinoma.

Endoscopic ultrasound can also be used in conjunction with endoscopicretrograde cholangio pancreatography. The ultrasound probe is used tolocate gall stones which may have migrated into the common bile duct.

Endoscopic ultrasound can also be used for imaging of the rectum andcolon, although these applications are lesser known. Endoscopicultrasound can be used primarily to stage newly diagnosed rectal or analcancer. EUS-guided fine needle aspiration may be used to sample lymphnodes during this procedure. Evaluation of the integrity of the analsphincters may also be done during lower EUS procedures.

An endoscopic ultrasound probe placed in the esophagus can also be usedto visualize lymph nodes in the chest surrounding the airways (bronchi),which is important for the staging of lung cancer. Ultrasound can alsobe performed with an endoscopic probe inside the bronchi themselves, atechnique known as endobronchial ultrasound.

EMBODIMENT 1

First of all, a first embodiment of the present invention is describedwith reference to FIGS. 1 to 8 .

FIGS. 1 and 2 both show a perspective view of a first embodiment of anendoscope head 1 according to the invention. More precisely, FIG. 1shows a disassembled state of the endoscope head 1 and FIG. 2 shows theassembled state.

The endoscope head 1 shown in the Figures forms part of an endoscopeaccording to the invention. This endoscope may be formed as a flexibleendoscope for the gastro-intestinal tract. The endoscope comprises anoperation unit and an insertion portion. The operation unit ispositioned on the proximal side and the insertion portion is positionedon the distal side of the endoscope. The operation unit (not shown inthe drawings) comprises an actuating lever (such as a joystick or asimple lever arm, for example) for actuating an Albarran lever, aworking channel inlet and an adjusting knob for bending a bendingportion of the endoscope. The operation unit is connected to a videoprocessor, a light source device, a display device and the like.

The insertion portion is a long tube-like element. The proximal end ofthe insertion portion is connected with the operation unit. Theinsertion portion comprises, in this order seen from the operation unit,a flexible portion, the bending portion and a cap. The flexible portionis elastic. The bending portion is bent as a reaction to an actuation ofthe adjusting knob. A rigid end piece portion is formed on the distalend of the bending portion. The rigid end piece portion forms theso-called endoscope head.

The inventive endoscope head 1 of FIGS. 1 and 2 comprises a longitudinalendoscope head body 11 and a subsequently further described housingsheath part 3 including a subsequently further described Albarran lever20.

The endoscope head body 11 is constructed in a cylinder-like manner and,on the distal side thereof, provided with an ultrasonic head chamber 4in which an ultrasonic head 40 is installed. On its proximal side, theendoscope head body 11 is connected to an operation unit (not shown) viaa cable (not shown) or without a cable. The operation unit is used tocontrol the endoscope head 1.

The endoscope head body 11 comprises a working channel 13 and a pullingwire channel 14 (see FIG. 7 ), both extending along the longitudinaldirection of the endoscope head body 11 and parallel to each other. Thepulling wire channel 14 contains a subsequently described pulling wirefor actuating the subsequently described Albarran lever 20. The workingchannel 13 guides micro tools for examining e.g. the esophagus or theduodenum, the bile duct, the gall bladder, the pancreatic duct, thepancreas, etc. The Albarran lever 20 which is described below and ableto change the lateral alignment of the micro tools in the known manneris arranged at the outlet of the working channel 13. In other words, theAlbarran lever 20 changes the alignment angle of the micro toolsadvanced through the working channel 13 in parallel to the axis of theendoscope head 1. The alignment of the micro tools is then changed to alateral direction by means of the Albarran lever 20, the micro toolsthen project laterally from the endoscope head so as to be advanced in abile duct, for example.

The shape and the deflection angle of the Albarran lever are notrestricted in the present invention.

As shown in FIGS. 1, 2 and 5 , the endoscope head body 11 comprises anAlbarran lever chamber 12 extending in the embodiment from a region nearthe longitudinal axis of the endoscope head body 11 in the radialdirection. In other words, the Albarran lever chamber 12 is open in theradial direction. Moreover, the Albarran lever chamber 12 extends in theaxial direction of the endoscope head body 11. On the proximal side ofthe Albarran lever chamber 12, the working channel 13 enters into theAlbarran lever chamber 12. On the distal side of the Albarran leverchamber 12, the ultrasonic head chamber 4 is provided.

The endoscope head body 11 comprises two lateral extension portions 11Aand 11B which are formed as side walls or side portions and are adjacentto the Albarran lever chamber 12. More precisely, as is shown in FIGS.1, 2 and 6 to 8, the endoscope head body 11 includes a first sideportion 11A for a camera and an illumination means, and a second sideportion 11B for a pulling wire.

A camera 17 and an illumination means 18, aligned laterally upwards inFIGS. 1, 2 and 6 to 8 , are installed in the first side portion 11A. Thedirection in which the camera 17 and the illumination means 18 arealigned is defined as the viewing direction. In the embodiment, theillumination means 18 is positioned on the distal end of the first sideportion 11A and the camera 17 is provided proximally to the illuminationmeans 18. Thus, the supply lines and signal lines for the camera 17 andthe illumination means 18 can be arranged inside the first side portion11A. These supply lines and signal lines extend toward the operationunit.

As is described below in further detail, a pulling wire channel 14 as amovement transmission channel, a pulling wire end and a pivot lever 6are accommodated in the second side portion 11B.

On the side directed to the viewing direction, the first side portion11A and the second side portion 11B are formed in a flat manner suchthat a flattening 19 of the endoscope head body 11 is provided. Theflattening 19 of the endoscope head body 11 is a plane surface facingtoward the viewing direction. In the embodiment, the camera 17 and theillumination means 18 are arranged distally to the flattening 19.

Thus, the Albarran lever chamber 12 is sandwiched between and laterallydelimited by the first side portion 11A and the second side portion 11B.The limitation walls of the first side portion 11A and the second sideportion 11B extend in an approximately radial direction in parallel toeach other. Thus, the Albarran lever chamber 12 in the embodiment has acuboid shape. The limitation walls of the first side portion 11A and thesecond side portion 11B are perpendicular to the flattening 19.

An accommodation chamber 11B1 is formed in the second side portion 11B.On the distal side, on the proximal side, on the side facing towards theAlbarran lever chamber 12, on the side facing towards the viewingdirection and on the side opposed to the viewing direction, theaccommodation chamber 11B1 is surrounded by the second side portion 11Band is open only on the side opposed to the Albarran lever chamber 12.The pulling wire channel 14, in which a pulling wire (control wire, notshown) is guided, opens out on the proximal side of the accommodationchamber 11B1. The pulling wire (control wire) extends up to theoperation unit and is actuated by the actuating lever for actuating anAlbarran lever.

A pivot lever 6 is rotatably supported in the accommodation chamber 111.More precisely, a bearing bore (passage bore) 11B2 extends through thewall of the accommodation chamber 11B1, which is provided on the sidefacing towards the Albarran lever chamber 12. This bearing bore 11B2connects the accommodation chamber 11B1 with the Albarran lever chamber12. The pivot lever rotating shaft 62 of the pivot lever 6 is rotatablysupported in the bearing bore 11B2. The pivot lever rotating shaft 62protrudes on both sides of the bearing bore 11B2, i.e. on the side ofthe accommodation chamber 11B1 and on the side of the Albarran leverchamber 12. The pivot lever rotating shaft 62 is installed in a sealedmanner in the bearing bore 11B2. Thus, the accommodation chamber is(watertightly) sealed against the Albarran lever chamber 12. The pivotlever rotating shaft 62 is formed perpendicularly to the pivot lever 6and integrally with the pivot lever 6 on an end portion of the pivotlever 6. The pivot lever rotating shaft 62 and the pivot lever 6 may beformed as one body or may be separate components which are connectedwith each other in a form-fitting or force-fitting manner. The pivotlever 6 has a pulling wire nipple accommodation 63 on the end portionopposed to the pivot lever rotating shaft 62. The pulling wire nippleaccommodation 63 may be molded to the pivot lever 6 or fixed to thepivot lever 6 as a separate body. The distal pulling wire end of thepulling wire is hooked in or fitted in the pulling wire nippleaccommodation 63 or otherwise fixed thereto.

The open side of the accommodation chamber 11B1, i.e. the side of theaccommodation chamber 11B1 opposed to the Albarran lever chamber 12, isclosed by a cover member 5. The cover member 5 is a flat plate memberadapted to the outer contour of the endoscope head body 11 and has asuitable size completely covering the open side of the accommodationchamber 11B1. The cover member 5 covers the open side of theaccommodation chamber 11B1 in such a manner that the open side of theaccommodation chamber 11B1 is (watertightly) sealed. For example, thecover member 5 is screwed to the outer circumference of the endoscopehead body 11 by means of two screws so as to cover the accommodationchamber 11B1, as it is shown in FIG. 1 . Thus, the accommodation chamber11B1, except for the pulling wire channel, is completely sealed. Inother words, the pulling wire channel is completely sealed against theenvironment (in a watertight manner).

On the end of the pivot lever rotating shaft 62, arranged in theAlbarran lever chamber 12, the pin 16 formed as a round rod body isarranged as an operating element. The pin 16 extends from the pivotlever rotating shaft 62 approximately in parallel to the pivot lever 6.However, the pin 16 may also extend from the pivot lever rotating shaft62 at a predetermined angle offset with respect to the pivot lever 6 inthe proximal or the distal direction. The relative extension directionof the pin 16 and the pivot lever 6 is not restricted in the inventionand can be appropriately selected.

Thus, the pin 16 can be actuated by means of the actuating lever of theoperation unit by pulling the pulling wire via the actuating lever; thiscauses the pulling wire nipple accommodation 63 to be pivoted about thepivot lever rotating shaft 62 as rotation point and the pin 16 to berotated about the same angular extent.

An Albarran lever described in the following can be placed on the pin16.

An ultrasonic head chamber 4 is arranged on the distal side of theendoscope head body 11. The ultrasonic head chamber 4 may be constructedin any suitable manner and holds the ultrasonic head 40 therein suchthat the ultrasonic head 40 is at least aligned to the viewingdirection. The ultrasonic head 40 is capable of transmitting andreceiving ultrasonic signals in the viewing direction. Ideally, theultrasonic head 40 is configured such that it is capable of transmittingand receiving ultrasonic signals in and from directions which are notlimited to the viewing direction alone.

The ultrasonic head chamber 4 may be mounted on the distal side of theendoscope head body 11 or form an integral unit with the endoscope headbody 11. Alternatively, the ultrasonic head chamber 4 may be dismountedon the distal side of the endoscope head body 11.

As it is shown in FIG. 1 , grooves 15 extending in the axial directionof the endoscope head body 11 are provided on the endoscope head body11. More precisely, a first groove 15 is formed on the first sideportion 11A below the accommodation chamber 11B1 (i.e. on the sideopposed to the flattening 19) on the outer circumferential surface ofthe endoscope head body 11.

A second groove 15 is provided on the second side portion 11B on thesame level as the first groove 15 and parallel to the first groove 15.The second groove 15 is not visible in the drawings since it ispositioned on the side of the endoscope head body 11, which faces awayfrom the viewer.

The first groove 15 and the second groove 15 are formed as longitudinalrecesses or depressions.

The housing sheath part 3 comprises a sheath 31 having a hollowcylinder-like shape. The inner contour of the sheath 31 of the housingsheath part 3 is adapted to the outer contour of the endoscope head body11. More precisely, the hollow cylinder shape of the sheath 31 is openon one cylinder sheath side. Thus, the sheath 31 includes two lateralextensions which are elastic. The cylinder sheath side of the sheath 31is open between the ends of the lateral extensions. The sheath 31 iselastic and can be bent open on the lateral extensions thereof. Thus, anattachment opening 32 is provided between the ends of the lateralextensions. Since the housing sheath part 3 is elastic, the attachmentopening 32 can be expanded by bending open the sheath ends adjacent tothe attachment opening 32. When the lateral extensions of the sheath 31are bent open, the housing sheath part 3 can be placed on the endoscopehead body 11 by inserting the endoscope head body 11 quasi through theattachment opening 32 into the sheath 31, see FIGS. 1 and 2 .

On the circumferential side opposed to the attachment opening 32, thehousing sheath part 3 has a tool opening 33 extending in the axialdirection of the housing sheath part 3. When the housing sheath part 3is placed on the endoscope head body 11, the tool opening 33 is arrangedexactly above the Albarran lever chamber 12. The size (in particular thewidth) of the tool opening 33 is adapted to the Albarran lever chamber12.

On the lateral extensions of the sheath 31, on the end portion opposedto the tool opening 33, ribs 35 are formed adjacent to the attachmentopening 32, as this is shown in FIGS. 3 to 5 . Each rib 35 extends inthe axial direction of the housing sheath part 3. When the housingsheath part 3 is placed on the endoscope head body 11, the ribs 35engage in the grooves 15. The shape and size of the ribs 35 is suitablyadapted to the shape and size of the grooves 15.

On the inner circumferential side, adjacent to the tool opening 33, thehousing sheath part 3 has a housing sheath flattening adapted to theflattening 19. In this region adjacent to the tool opening 33, thehousing sheath flattening is provided with a thicker wall thickness thanthe rest of the sheath 31. When the housing sheath part 3 is placed onthe endoscope head body 11, the housing sheath flattening abuts againstthe flattening 19. On an axial side of the tool opening 33, a protrusion34 is formed on the housing sheath flattening. The protrusion 34 extendsradially inwards in the housing sheath part 3, perpendicular to thehousing sheath flattening. The protrusion 34 forms an Albarran leverholder. The protrusion 34 is formed to be flat and projects into theAlbarran lever chamber 12 when the housing sheath part 3 is arranged onthe endoscope head body 11.

On the end portion opposed to the housing sheath flattening, theprotrusion 34 has a passage bore 341 formed perpendicular to theextension direction of the protrusion 34 and perpendicular to the axisof the housing sheath part 3. An Albarran lever shaft 21 is rotatablysupported in the passage bore 341. The Albarran lever shaft 21 protrudeslaterally from the Albarran lever 20, as it is shown in FIG. 3 . Thus,the Albarran lever 20 is rotatably supported on the radially inner endportion of the protrusion 34.

The Albarran lever 20 has an insertion bore which is not shown in thedrawings and in which the previously described pin 16 is inserted. Theinner diameter of the insertion bore of the Albarran lever 20 is adaptedto the outer diameter of the pin 16, such that a smooth relativedisplacement between the pin 16 and the insertion bore of the Albarranlever 20 is realized.

When the housing sheath part 3 is placed on the endoscope head body 11,the Albarran lever 20 is slid on the pin 16. In other words, in thisposition the pin 16 engages in the Albarran lever 20 and can pivot theAlbarran lever. Thus, the Albarran lever 20 can be applied (inserted) onthe endoscope head body 11 laterally to the axis of the endoscope headbody 11 and, in turn, removed from the endoscope head body 11 laterallyto the axis of the endoscope head body 11.

When the housing sheath part 3 is placed on the endoscope head body 11,the Albarran lever shaft 21 is arranged at a position which forms animagined extension to the pivot lever rotating shaft 62.

The Albarran lever 20 may have any suitable shape and includes a toolpushing surface 22. By means of the tool pushing surface 22, toolsguided through the working channel 13 can be pushed to the lateral sideof the endoscope head body 11 in the known manner. In the installedstate of the Albarran lever 20, the tool pushing surface 22 ispositioned opposite to the orifice of the working channel 13 into theAlbarran lever chamber 12.

The Albarran lever 20 can be slid on the pin 16 such that it extendsapproximately parallel to the pivot lever 6, as it is shown in FIGS. 6and 7 . Thus, in a state when the housing sheath part 3 is placed on theendoscope head body 11, there are two end positions for the position ofthe Albarran lever 20. FIG. 6 shows the Albarran lever 20 in anon-pivoted state with the pulling wire being released. FIG. 7 shows theAlbarran lever 20 in a pivoted state with the pulling wire being pulled.

The housing sheath part 3 and the Albarran lever 20 form a commonassembly. The housing sheath part 3 and the Albarran lever 20 are eachmade of plastic or any other cost-efficient material. They can becost-efficiently manufactured by means of injection molding or a3D-printer. Thus, the assembly consisting of the housing sheath part 3and the Albarran lever 20 is suitable for single use. After the use, theassembly consisting of the housing sheath part 3 and the Albarran lever20 can be disposed of. The endoscope itself comprising the endoscopehead body 11 according to the invention includes hardly any undercutsand is therefore easy to clean. The Albarran lever 20, on the otherhand, includes undercuts and is more difficult to clean. Germs andcontaminations might remain stuck to locations of the Albarran leverthat are difficult to access. In the present invention, this problem issolved by designing the assembly consisting of the housing sheath part 3and the Albarran lever 20 such that it is replaceable. For the nextapplication, the cleaned and sterilized endoscope is provided with a newassembly of housing sheath part 3 and Albarran lever 20. In this way,the endoscope can be cost-effectively used again after an application,namely free of germs and contaminations.

The Albarran lever is completely separated from the pulling wire. Due tothis construction, the pulling wire channel is sealed, with the pullingwire being completely sealed against the environment. The sealing of thepulling wire channel and the pulling wire is watertight.

Preferably, the housing sheath part as an Albarran lever holding memberand the Albarran lever are made of plastic by means of a 3D-printer orinjection molding, for example. By the manufacturing by means of a3D-printer or injection molding, the housing sheath part and theAlbarran lever can be manufactured accurately, but still at low cost.Other appropriate manufacturing methods may be applied as long as theyallow for an accurate and cost-efficient production. Preferably, thehousing sheath part and the Albarran lever are manufactured separatelyand then put together as an assembly for the purpose of a single use.

In a molding step, the housing sheath part as sheath element and theAlbarran lever are separately manufactured and in an assembly step, theAlbarran lever is installed in the housing sheath part.

EMBODIMENT 2

In the following, a second embodiment of the present invention isdescribed with reference to FIGS. 9 to 13 .

In the first embodiment, the housing sheath part 3 is engaged at theendoscope head body 11 by the ribs 35 engaging in the grooves 15. Thus,in the first embodiment, the ribs 35 and the grooves 15 represent thefastening means by which the housing sheath part 3 is attached to theendoscope head body 11.

In the second embodiment, the endoscope head 1 of the first embodimentand a housing sheath part 3 modified compared to the housing sheath part3 of the first embodiment, are applied. Therefore, only those aspects inwhich the second embodiment differs from the first embodiment aredescribed in the following.

In the second embodiment, another (additional) fastening means in theshape of a hinge member 310 is provided on the housing sheath part 3.The hinge member 310 bridges over the attachment opening 32. One side ofthe hinge member 310 is supported in a hinged manner on the housingsheath part 3 in an edge region of the attachment opening 32. Theopposite side of the hinge member 310 includes a closing means, such asa nose 311, capable of engaging in an engagement groove 315 on theopposite edge region of the attachment opening 32 at the housing sheathpart 3.

The hinge mechanism of the hinge member 310 on the housing sheath part 3may be formed as a film hinge. More precisely, the hinge member 310 isintegrally provided on the housing sheath part 3 as a thin-walledconnection (e.g. in the shape of a fold). Due to its flexibility, thethin-walled connection enables a rotational movement of the hinge member310 on the housing sheath part 3. Manufacturing the film hinge isextremely cost-effective.

Apart from that, the housing sheath part 3 corresponds to the housingsheath part 3 of the first embodiment.

EMBODIMENT 3

FIG. 14 shows a perspective view of an inventive housing sheath part ofa third embodiment.

In the third embodiment, the endoscope head 1 of the first embodimentand a housing sheath part 3 modified compared to the housing sheath part3 of the first embodiment are applied. In the first embodiment, thehousing sheath part 3, in the region of the housing sheath flatteningadjacent to the tool opening 33, has a thicker wall thickness than therest of the sheath 31.

In the third embodiment, a housing sheath part 3 also includes theregion of the housing sheath flattening, which is adjacent to the toolopening 33, as it is shown in FIG. 14 . However, the housing sheath part3 does not include the two lateral extensions of the first embodimentwhich comprise the ribs 35 and the ends of which define the attachmentopening 32. As opposed to the first embodiment, the housing sheath part3 in the third embodiment includes only that portion of the housingsheath flattening which is adjacent to the tool opening 33. On each ofthe lateral sides of the portion of the housing sheath flattening, thehousing sheath part 3 is provided with a fastening means in the shape ofa hinge member 320. One side of the hinge member 320 is, on an edgeregion of the portion of the housing sheath flattening, supported on thehousing sheath part 3 via a hinge mechanism 322. The opposite side ofthe hinge member 320 includes a closing means such as a nose 321 whichcan engage at the endoscope head body in an engagement groove providedfor this purpose.

The hinge mechanism of the two hinge members 320 on the housing sheathpart 3 may be designed as a film hinge 322. More precisely, each of thehinge members 320 is integrally provided on the housing sheath part 3 inthe shape of a thin-walled connection as a film hinge 322 (e.g. as afold). Due to its flexibility, the thin-walled connection of the filmhinge 322 enables a rotational movement of the hinge member 320 on thehousing sheath part 3. The manufacture of the film hinge 322 isextremely cost-effective.

Alternatives

In embodiment 1, the rib 35 is provided as a fastening means which isformed at the housing sheath part 3 and engages with the groove 15 ofthe endoscope head body 11. Adjacent to the attachment opening 32, aright and a left rib 35 is provided, each being parallel to theextension direction of the endoscope head body 11. The invention is notrestricted thereto. Instead of the rib 35, one or more pin-likeprotrusions may be formed on the housing sheath part 3, whichrespectively engage in one or more hole-like recesses on the endoscopehead body 11 instead of the groove 15. Any type of fastening means ispossible, as long as the same ensures that the housing sheath part 3 issecurely held in place at the endoscope head body 11. Thus, as a matterof fact, the rib 35 may also be formed on the endoscope head body 11 andthe groove 15 acting together with the rib 35 may be formed on thehousing sheath part 3. Further, screws by which the housing sheath partis screwed to the endoscope head body may be used as fastening means.“Fastening means” thus refers to any releasable fastening means.

In embodiment 1, the region of the housing sheath flattening on thehousing sheath part 3 is formed such that the wall thickness of thehousing sheath part 3 is reinforced (see the drawings). Thereby, thehousing sheath part 3 becomes more rigid and more stable. The inventionis not restricted thereto. The wall thickness of the housing sheath part3 may also be uniform.

In embodiment 1, a protrusion 34 is shown as Albarran lever holder. Theprotrusion 34 extends approximately radially inward in the housingsheath part 3, in a manner perpendicular to the housing sheathflattening. In other words, the protrusion 34 projects downward from thehousing sheath part 3. In the drawings, the protrusion 34 projects fromthe housing sheath part 3 downward into the Albarran lever chamber 12 onthe right-hand side of the Albarran lever chamber 12, seen from thedistal side. In an alternative, two flat protrusions 34 may protrudedownward from the housing sheath part 3 into the Albarran lever chamber12 on the right-hand and left-hand side of the Albarran lever chamber12, seen from the distal side. On the end portion opposite to thehousing sheath flattening, each of these two protrusions 34 has apassage bore 341 in each of which a shaft end of the Albarran levershaft 21 is rotatably supported. Then, the Albarran lever is supportedin the housing sheath part 3 in a more stable manner.

In embodiment 1, the cover member 5 is screwed to the outercircumference of the endoscope head body 11 by means of two screws, soas to cover the accommodation chamber 11B1. Here, it is also possible touse one screw or more than two screws. Moreover, the cover member 5 maybe glued to the outer circumference of the endoscope head body 11, so asto cover the accommodation chamber 11B1. As a further alternative, thecover member 5 may be releasably attached to the outer circumference ofthe endoscope head body 11 by locking-engagement, so as to cover theaccommodation chamber 11B1.

In the second embodiment, the ribs 35 and the grooves 15 may be omitted.The housing sheath part 3 can then be kept closed by the hinge member310 only and tightly abuts against the endoscope head body 11. Thehousing sheath part 3 is aligned towards the endoscope head body 11 viathe connection between the Albarran lever 20 and the pin 16. In thisway, the relative position between the housing sheath part 3 and theendoscope head body 11 is sufficiently specified.

In the first embodiment, the ends of the sheath 31 which are opposed tothe flattening 19 and form the edge regions of the attachment opening 32are formed to be thin on the housing sheath part 3, as it is shown inFIG. 4 , for example. In an alternative not shown in the drawings, theends of the sheath 31 which are opposed to the flattening 19 have athicker wall thickness and are provided with round U-depressionsextending in parallel to the axial direction of the housing sheath part3. The U-depressions are open towards the attachment opening 32. Roundrod elements of an appropriate size can be inserted into theU-depressions. The round rod elements constitute the respective sideedges of a plate member (not shown) inserted into the above-mentionedU-depressions from the distal or the proximal side. The round rodelements are formed in one piece with the plate member. TheU-depressions have a smaller opening dimension on the open side so as tosafely hold the round rods. Thus, the round rod elements can besnap-fitted into the U-depressions and are rotatably supported in theU-depressions. The plate member bridges over and closes the attachmentopening 32.

In a similar alternative, one of the two round rod elements of the platemember is fixedly seated in its U-depression of the housing sheath part,is rotatably supported thereon and cannot be pulled out. The other oneof the two round rod elements is snap-fitted in its U-depression. Then,the plate member functions in much the same way as the hinge member 310of the second embodiment. This means, one of the two round rod elementsof the plate member is used as pivot bearing of the plate member on thehousing sheath part 3 and the other one of the two round rod elements ofthe plate member is used as a closing member of the plate member on thehousing sheath part 3.

Fastening means fastening the housing sheath part 3 to the endoscopehead body 11 are described in the embodiments. The rib 35, the groove 15and the hinge member 310, 320 are specifically mentioned as examples.The invention is not restricted thereto. The term “fastening means”shall include any fastening means suitable to fasten the housing sheathpart 3 to the endoscope head body 11. The fastening means may beattached to the housing sheath part 3 or to the endoscope head body 11or to both of them. It is also possible to use one (or more) externalfastening means attached neither to the housing sheath part 3 nor to theendoscope head body 11, such as, for example, an external annular memberwhich is slid on or clamped on the outer circumference of the housingsheath part 3 and the endoscope head body 11 in FIG. 2 of embodiment 1.In case an external fastening means is applied, fastening means attachedto the housing sheath part 3 or the endoscope head body 11 (the rib 35,the groove 15 and the hinge member 310, 320) may be omitted.

In the embodiments, the ultrasonic head is arranged on the distal end ofthe endoscope head, and the endoscope head includes an Albarran leverarranged proximally from the ultrasonic head. The invention may also beapplied to an endoscope head including an Albarran lever arrangeddistally from the ultrasonic head. In this alternative, a workingchannel and a movement transmission channel are guided past theultrasonic head. This can be easily accomplished by arranging, withreference to FIG. 1 , an ultrasonic head chamber similar to theultrasonic head chamber 4 between the proximal portion of the endoscope1 and the endoscope head body 11. The endoscope head body 11 is thenarranged on the distal end of the endoscope. The ultrasonic head chamber4 is arranged proximally of the endoscope head body 11, the bottomregion of the ultrasonic head chamber 4 including a working channelportion and a movement transmission channel portion, extending below theultrasonic head 40 in the bottom region of the ultrasonic head chamber 4towards the endoscope head body 11.

The described alternatives may be combined and may be applied to allembodiments.

The present invention may preferably be applied to a duodenoscope, agastroscope, a colonoscope or a similar endoscope. However, theprinciple of the invention may as well be applied to any other type ofendoscope.

LIST OF REFERENCE SIGNS

-   -   1 endoscope head    -   3 housing sheath part    -   4 ultrasonic head chamber    -   5 cover member    -   6 pivot lever    -   11 endoscope head body    -   11A side portion for camera and illumination means    -   11B side portion for pulling wire    -   11B1 accommodation chamber    -   11B2 bearing bore    -   12 Albarran lever chamber    -   13 working channel    -   14 pulling wire channel    -   15 groove (fastening means)    -   16 pin (operating element)    -   17 camera    -   18 illumination means    -   19 flattening    -   20 Albarran lever    -   21 Albarran lever shaft    -   22 Albarran lever tool pushing surface    -   31 sheath    -   32 attachment opening    -   33 tool opening    -   34 Albarran lever holder (protrusion)    -   35 rib (fastening means)    -   40 ultrasonic head    -   62 pivot lever rotating shaft    -   63 pulling wire nipple accommodation    -   310 hinge member (fastening means)    -   311 nose    -   315 engagement groove    -   320 hinge member (fastening means)    -   321 nose    -   322 film hinge    -   341 bore for Albarran lever shaft

The invention claimed is:
 1. A housing sheath attachable to anddetachable from an endoscope head body, which is provided on a distalside of an insertion portion of an endoscope, the housing sheathcomprising: a sheath that is a hollow cylinder open at an attachmentopening provided along a longitudinal direction of the hollow cylinder,and is provided with a tool opening cut out in a U-shape at a locationfacing the attachment opening, the sheath comprising two hinges that areconnected to both edges of the attachment opening and include engagementmembers configured to engage with each other, the hinges configured todetachably engage with the endoscope head body at an edge of theattachment opening; and an Albarran lever that is rotatably supportedinside the sheath.
 2. The housing sheath according to claim 1, whereinthe Albarran lever detachably engages with a pivot lever rotatablyprovided on the endoscope head body.
 3. The housing sheath accordingclaim 1, further comprising a housing sheath flat portion on an innersurface of the housing sheath at the location facing the attachmentopening.
 4. The housing sheath according to claim 3, wherein the housingsheath has a protrusion protruding from the housing sheath flat portiontoward the attachment opening, the Albarran lever has, at a proximalportion, an Albarran lever shaft rotatably supported by the protrusion,and a tool pushing surface provided at an end portion of the Albarranlever moves toward the tool opening as the Albarran lever rotates aboutthe Albarran lever shaft as an axis.
 5. The housing sheath according toclaim 1, wherein the endoscope includes a convex-shaped ultrasonic headthat is disposed at an end portion of the endoscope head body andcapable of transmitting and receiving ultrasonic signals in a lateralviewing direction, and when attached to the endoscope head body, theAlbarran lever is disposed inside an Albarran lever chamber, which isopen continuously at the end portion and a side surface of the endoscopehead body, and is rotatable with respect to the ultrasonic head.
 6. Thehousing sheath according to claim 1, wherein the sheath forms a commonassembly with the Albarran lever, wherein the common assembly of thehousing sheath and the Albarran lever can be attached to and removedfrom the endoscope head body as one single unit.
 7. The housing sheathaccording to claim 1, wherein the sheath is formed as a laterally opencylinder whose open side can be attached to the endoscope head body, theAlbarran lever pivotally supported in the sheath has an opening adaptedto be able to engage in an operating element supported on the endoscopehead body.
 8. An ultrasonic endoscope comprising: an endoscope head bodythat is disposed on a distal side of an insertion portion of theendoscope and is provided with an Albarran lever chamber which is opencontinuously at an end portion and a side surface of the endoscope headbody; a convex-shaped ultrasonic head that is disposed at the endportion of the endoscope head body and capable of transmitting andreceiving ultrasonic signals in a lateral viewing directioncorresponding to the side surface of the endoscope head body; and ahousing sheath including a hollow cylinder open at an attachment openingprovided along a longitudinal direction of the hollow cylinder androtatably supporting an Albarran lever inside, the housing sheathcomprising two hinges that are connected to both edges of the attachmentopening and include engagement members configured to engage with eachother, the hinges being attachable to and detachable from the endoscopehead body at an edge of the attachment opening, wherein the Albarranlever chamber accommodates the Albarran lever when the housing sheath isattached.
 9. The ultrasonic endoscope according to claim 8, wherein theendoscope head body has a flat portion that surrounds three sides of theAlbarran lever chamber and extends along a longitudinal direction of theinsertion portion.
 10. The ultrasonic endoscope according to claim 9,wherein the endoscope head body has a wall extending from the flatportion on a proximal side of the Albarran lever chamber, said wallforming the proximal side of the Albarran lever chamber.
 11. Theultrasonic endoscope according to claim 9, wherein when the housingsheath is attached, the flat portion abuts on a housing sheath flatportion provided on an inner surface of the housing sheath at a locationfacing the attachment opening.
 12. The ultrasonic endoscope according toclaim 8, further comprising a pin inside the Albarran lever chamber androtatable with respect to the ultrasonic head, the pin having a rotatingshaft, wherein the pin detachably engages with the Albarran lever. 13.The ultrasonic endoscope according to claim 12, wherein the pin is fixedto a pivot lever that forms the rotating shaft and is rotatablysupported by the endoscope head body, and the pivot lever rotates inconjunction with an operation of an operation unit of the endoscope.